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Health Matters: Veterans face unique medical needs

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Experts say post-traumatic stress disorder and other mental health issues represent only a portion of medical conditions affected the nation’s veterans.

Former service personnel are 67 percent more likely to have heart attacks, 62 percent more likely to develop coronary heart disease and 13 percent more likely to get cancer. The rates are based on datA collected by United Health Foundation for its America’s Health Rankings report.

Those who saw combat in the Gulf War from 2003 to 2011 or during Vietnam have elevated rates of medical conditions linked to each group of veterans, the Veterans Administration reports.

On the plus side, military veterans are more likely to be physically active, have regular dental visits, get their flu shots and have colorectal cancer screenings. Obesity rates are lower among those who served.

But rates for smoking and excessive drinking remain higher among veterans, the America’s Health Rankings report shows.

For veterans, the good news is that a plethora of organizations are working to bring attention and resources to the unique health concerns. The groups focus on educating veterans about what’s available through the Veterans Health Administration, while providing additional support to fill gaps in the VA benefits.

The James E. Van Zandt VA Medical Center in Altoona and its community-based outreach clinic at The Galleria complex in Richland are available to most former service members.

Tom Caulfield, executive director and president of Veterans Community Initiatives in Johnstown, said the groups have begun coordinating efforts to create a network of support.

“We have been fostering that relationship with the Altoona VA hospital and the Johnstown clinic,” Caulfield said in the Veterans Community Initiatives office in Hiram G. Andrews Center, 727 Goucher St.

“We want everybody to know each other,” he said.

Veterans often don’t know what benefits are available to cover their health care costs, because the Veterans Benefits Administration has complicated eligibility rules. Enrollment is based on eight priority groups to ensure benefits are available.

Those who receive benefits can get medical needs covered through the Veterans Health Administration hospitals and clinics. The Veterans Benefits Administration, Veterans Health Administration and National Cemetery Administration are the three division of the federal Department of Veterans Affairs.

A majority of area veterans who do not qualify for federal benefits may still use the VA health system with coverage by private insurance or Medicare, Shaun Shenk, public affairs officer, said at the Altoona hospital.

“Most veterans are eligible to come to the VA,” Shenk said.

“You actually can use the VA for all your health care.”

Veterans can come to the VA or visit their county director of veterans affairs for help with benefits, he added.

“Every veteran is different, and there are several pieces of information that determine eligibility,” Shenk said. “I would encourage all veterans who are uncertain about their eligibility to come visit us and sit down with one of our enrollment specialists.”

In Cambria County, Veterans Affairs Director Josh Hauser says his biggest job is finding benefits for those who served in the military.

Eligibility changes over time, Hauser stressed, adding that veterans should check periodically to be sure they are receiving all the benefits they have earned.

In addition, the VA medical system has adapted to better serve its patients, Hauser said.

“One of the more overwhelming populations were are seeing is our Vietnam Era veterans,” Hauser said. “It was, historically, a very turbulent time, and the VA was in a different place.”

“These veterans have had no interaction with the VA or the military after leaving. Or they didn’t have a pleasant experience 40 years ago and they are just coming back now.”

Ischemic heart disease, diabetes, neuropathy, lung disease, prostate cancer and Parkinson’s disease are among the conditions reported, he said.

All six of those diseases are on the list of 14 conditions with recognized links with exposure to Agent Orange, a defoliant used in Vietnam and other areas during the war era, Dr. Marquita Decker-Palmer, associate director, said at the 1889 Jefferson Center for Population Health in Johnstown.

There is a shorter list of conditions associated with Gulf War veterans, Decker-Palmer said at the population health center headquarters in the Crown American Building. The Gulf War list may grow as the Veterans Health Administration completes more research.

The Gulf War list includes a group of “medically unexplained illnesses” and applies to those who served in areas of Southwest Asia from 2003-11, including Operation Iraqi Freedom and Operation New Dawn.

The illnesses, characterized by a group of symptoms, include chronic fatigue syndrome, fibromyalgia and functional gastrointestinal disorders.

“There isn’t a specific, known disease, but the G-I tract does not function they way it should,” Decker-Palmer said. “It often includes irritable bowel syndromeexplaining the gastrointestinal disorders.

Although the cause of the Gulf War syndromes is not known, some suggest they are linked to burn pits or lingering effects of infectious diseases, Decker-Palmer said.

In addition to seeking the VA health system’s expertise, veterans should take heed of the same advice given to anyone who wants to reduce their health risks and medical expenses, Michelle George, community projects manager, said at the population health center.

“What they need to do is get the preventive screenings, live healthier lifestyles and get the treatment they need,” George said.

“The biggest issue for veterans has been smoking,” Decker-Palmer said.

About 20 percent of men and women who served report that they smoke. That is about the same as the rate for men in the general population, but it is about 25 percent higher than the rate of 16 percent for women in the general population.

Veterans have been having more success with tobacco cessation, Decker-Palmer said.

Seventy percent of veterans who were smokers have been quit. That’s up from just 50 percent in 2012, Decker-Palmer said.

From a population health viewpoint, Decker-Palmer said more attention needs to be focused on mental health concerns among veterans. In addition to PTSD, veterans are more likely to report bouts of depression and anxiety.

Suicide rates for veterans remain high, accounting for about 20 percent of all deaths among veterans who served in Iraq of Afghanistan, Decker-Palmer said.

There has been increased attention to prevention and recovery following military sexual trauma, she said. One in 10 women who served say they experienced sexual assault in the military, with 40 percent saying they were sexually harassed.

About 0.5 percent of men experienced sexual assault and 4 percent were sexually harassed.

“The high percentage of military sexual assault among women, and the smaller but significant percentage of military sexual assault among men, indicates that research and health care service that address military sexual assault should continue the focus on veterans of both sexes,” the VA concluded in its report on the issue.

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© 2018 The Tribune-Democrat (Johnstown, Pa.)

Distributed by Tribune Content Agency, LLC.

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